Wednesday, March 16, 2016

Abby and Quinn's Story

Our Diagnosis Story




I've given birth to 6 children now. The day a new life joins our family is a day full of emotions. After the pain comes the joy. I have spent months worrying about this life inside me, hoping that everything will go well and they will be healthy. When they are born there is also such a relief. 10 fingers, 10 toes, a healthy set of lungs, and a clean bill of health from the Doctor.

Life goes on, and my newborn quickly grows as we learn about their sleeping habits, their quirks, and their personality. Some days are hard, as any Parent can understand, but the days are full of joy as well. 

Then the unthinkable happens. A year or two down the road, you start noticing worrisome changes. Frightening really. You realize that the healthy baby you had back in the hospital, really wasn't healthy at all. Their body was just keeping the truth from you, for a time.

The first time this happened with Abby, she was almost a year old. I went to change her diaper and as I opened it up, there were black streaks every where she peed. I remember she had a fever, but I was scared out of my mind. I took her to the E.R. that night. After a nurse speculated "maybe it was something she ate", the eventual diagnosis ended up being a Kidney Infection.


Thankfully, our pediatrician at the time had a lot of experience dealing with this type of problem and set us up for more testing and a visit to a Urologist. This started a very long road of catheters, (poor girl), urine checks, medicine, Doctor visits, and eventually surgery. The VCUG was a traumatizing test that let us know Abby had Kidney Reflux. After her second Kidney Infection in a month, we decided it was time to do a less invasive procedure to hopefully fix it.

I had such high hopes, oh... I knew we would be alright. When we did the next VCUG to see if the procedure had fixed it, I was devastated to learn that it did nothing. The only thing left was to put her on daily antibiotics to protect her kidneys from infection. Oh the irony! 

About 6 months after her first kidney infection, Abby woke up with green urine this time. I remember it clearly because the Nurse said she was just being festive for St. Patrick's Day. I hadn't even realized it was one of our favorite holidays that day. I assumed her green urine, streaked with black was the same as before. Another kidney infection. I was confused because she was on antibiotics, but maybe she was getting a resistance to them. We left the office with a new prescription that left her constantly nauseous. A few days later we got the call to stop the new medicine because she didn't have an infection. The culture came back normal. 

This problem persisted again and again. You can't not go to the Doctor when your child is having brown and black streaks in their diapers. They would give her a catheter and collect urine, and again it would come back that she didn't have an infection. By now Abby was 2 and was grabbing herself in pain every time she had to go to the bathroom. My Urologist shrugged his shoulders and said he had no more ideas. 

I guess I could go into more details of terrible doctors, but I will spare you the details. After I started seeing a Nephrologist (Kidney Doctor), I decided to get urine test strips and start documenting everything. I got her to collect samples so we didn't have to do catheters anymore. Everyday I would test her urine. Every time, the blood in her urine was too dark to even be listed on the bottle. She had protein a lot of the time and I started noticing something else. When her pH was low, she would actually pee out tissue! She was peeing out the lining of her bladder. I sent those samples in to the Doctors, and they had nothing to say. Eventually the Nephrologist got to the end and said he had no more ideas as well. 


I thought I would try Children's Hospitals next. I called one in Utah that was well known. After I talked to the Nurse about my observations and fears, she called me back and said all the Doctors would not look inside Abby. They wouldn't help her because she was too young. At my utter discouragement, I decided to call my first Urologist and tell him what was happening. He reluctantly decided that he would put her under and do a cystoscopy to see if anything was going on. 

While Abby was in recovery, he came out with pictures to explain what he saw. The first thing that came out of his mouth was, "Well you aren't making this up." ... DUH! Her Bladder had disfigured. Instead of being oval/round, it was in the shape of a horseshoe. There was a bulge on the bottom pushing everything up. The lining of the bladder had rolled and was open in a spot and was bleeding. His grand diagnosis, Constipation. He said he had never seen anything like this. I asked if it was normal for constipation to cause this, His answer, "No". 


All of these reasons were why a true diagnosis, of why there was blood AND protein in the urine, could not be found. We were side tracked and confused because she had a lot more going on. Every now and then a new puzzle was added to the mix. We tried a Hospital in California hoping to get answers. Again, nothing. 

Sometimes things have to go downhill in order to go back up. We had just moved to a new state and withing a month, Abby had another Kidney Infection. There was no reason for her to have one. She had been on daily antibiotics for years now, but alas, she got one. Have you heard the phrase "Tender Mercies"? We were supposed to be on a 3 month probation before we could have insurance. Kevin's new boss had just met with him and told him they were pushing it up and he could have it after a month of working, instead of 3. Tender Mercy. We just got the card in the mail when she got the infection. Because we were so new and on probation that first month, we hadn't chosen a Pediatrician yet. I called a Children's Clinic and took the first appointment with the on call Doctor. He treated her as normal but wanted details of her past, and scheduled a follow up. At her follow up appointment he wanted to figure out what was wrong. He had ideas but really wanted us to see a specialist. He wasn't accepting new patients, but because he helped us already, he agreed to keep seeing her. 

A month later, Quinn (my youngest at the time) woke up with streaks in his diaper. I had that same reoccurring moment of realization and devastation, that my once healthy baby, was really not healthy. This time, he never had an infection, yet he had a fever. I was so confused. A kidney infection is both. We learned by observation that when Quinn was sick with something like a cold, his urine got dark and left streaks, but he didn't have Kidney Reflux like Abby. 

Finally the day came for the referral to Utah to see the specialist. I had all records, all x rays, all blood work. I even wrote down a full page of information for the Doctor. I met up with my mom for the appointment and what she said shook me to my core. She said, "Natali, I know Abby seems worse, but I feel like you are missing something even worse with Quinn. You have to find out what is going on with him. Don't ignore it just because he rarely has the problem." I don't know how she said it, but she even mentioned she would give her kidney to him. I don't know how she knew.

Is it really shocking to you that this specialist appointment fell flat again? After more tests and the traumatic VCUG again, they eventually said, "Sorry, we can't help you." I went back to my pediatrician discouraged and he was actually happy. He assured me that this was a good thing that we eliminated them and he was going to send us somewhere new. I let fate take the wheel and let the receptionist tell me which Doctor I was going to see. After a new set of blood work and tests, we were finally ready for the appointment. 

This time was different. The Doctor wasn't just a one time stop to nothing. He had ideas, and more, he assured me that we would figure this out. He wanted to see us back, he wanted to monitor them, and he was concerned for me and the kids. Dealing with him and my pediatrician left me feeling HOPE, something I never left the Doctors feeling. For years I had nothing but fear and worry and dead ends. I tried to search for hours online hoping I could find answers that never came. I figured if I just read one more medical study, maybe I could figure it out. 

My pediatrician's guess was IGA Nephropathy. In that first appointment our Nephrologist said it was a possibility and he mentioned an X thing. I read about IGA and I didn't like that it said it ~might~ end up with kidney failure. I was hoping it wasn't that. I always assumed it wouldn't be that bad. I was just doing my job and not ignoring the problem. The only way to know for sure is a kidney biopsy. He doesn't like putting kids through that and his theory is that you only biopsy when you are ready to treat. If kidney functions are good, then there is no need for treatment, therefor a diagnosis can wait until it is necessary. 

This began our monthly testing for kidney functions. You have to catch their first urine of the day (which is hard with a baby in diapers) and then do blood work. Can we take a moment of silence for all moms who have to hold their traumatized child down for blood work? Yes, at the worst of all this, Abby and Quinn didn't want me at home when they cried. They wanted Dad. 

Functions were showing that even though Abby's urine looked more visibly worse, her numbers remained in a low range. (It is quite something when a Doctor who sees urine everyday, says your daughter's pee looks frightening.) Quinn, on the other hand would go from low to borderline severe when he got colds or other sicknesses.

I got the call from the Doctor finally. I shut and locked my door so I could hear him. He let me know that it was time to biopsy. He still couldn't make up his mind on who to biopsy. Abby was older and that carried fewer risks, but Quinn's numbers were worse. Before we got off the phone I asked him, "What was the name of the X thing you keep mentioning?" He replied, "Alport Syndrome". I hung up with him and googled it. 

As I read, everything fit this time. It fit so well I started crying. I just knew. I knew that this was what it was. I read that their kidneys WILL fail. I stopped for sometime as I cried and wiped my eyes. Then I read more and read that they will lose their hearing. I cried harder and tried to read more through my tears and saw that their eyes might be affected. At this point I shoved my keyboard forward and went into the bathroom and sobbed. I tried calling my husband, Kevin. He kept trying to calm me down and, being the optimist that he is, he tried telling me that they are going to be fine and to not worry. "You shouldn't get upset about what you read online." I am sure I got upset with him for saying that. 

I don't remember what happened an hour or so after that. I know I shut off the computer and walked away. After all the years of searching, I finally had my answer and I was mad. Pissed off, and depressed. Day 2 was much the same. Eventually I always come to the same conclusion when I feel this way. No amount of crying or feeling this way is going to change anything. There is no point to it and I can't go on like this. By the 3rd day I just kind of threw my hands in the air, figuratively speaking, and just said, "Whatever. This is the stupidest thing in the world. I'll wait to know for SURE." 

We prayed that the child who needed to have the biopsy would be chosen by the Doctor. We felt it was Quinn but didn't want to push or persuade him. We wanted the Doctor to choose who he felt needed it more and weigh the risks carefully. He did decide to biopsy Quinn and set it for December, since we had already met the deductible that year.


That story is for another day, but we got the results 2 days after Christmas. The Doctor didn't want to spoil our Christmas with the news that Quinn has Autosomal Recessive Alport Syndrome. One of the filters in his kidneys (there are 3) is not even there, and the other 2 are thin and are in different stages of repair. This is why the kids leak blood and protein when the pee. Their kidneys can't filter it all out, and it is the continual repair that leads to scar tissue and eventual failure. 

It didn't take me long to find support groups online. That has helped me so much. I can talk to mothers going through this, we can ask questions, and I get to hear from other people who have gone through kidney failure, but are still living a full life. I've feared that kidney failure was an "ending". I am learning that it is just a different way of life. God has placed me on a path. I might not have had half of my children if we had found out the answer when Abby was younger. It wasn't time back then. I can see that now. He has given me, what I call "my life saving team", the kids's Doctors. Without Abby getting an infection and getting our on call Doctor that day, I would still not have answers. He has placed people in our lives, my earthly angels, who lift us, love us, and comfort us. I can now see His help though all this and it gives me hope for the future.


This article was published in the book, "When a Diagnosis Changes Everything: A Collection of Stories from Mothers of Special Needs Children". Click Here to Purchase the eBook.


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Monday, March 7, 2016

What Alport Syndrome is Like for Little Kids

What Alport Syndrome is Like for Little Kids




I sat down to write about Alport Syndrome and Abby walked into the room to ask me a couple of questions. I suddenly had the idea to have her write about it instead. 

"Abby, What is it like having Alport Syndrome?"

Immediately her eyes widened, with a look of worry on her face. Every time I bring it up, she gets nervous. 

"Why Mom?" 

I can tell she doesn't want to talk about it. I tell her my idea and ask again.

"Well I have to take medicine every night. Sometimes the Doctors check my blood pressure. When I get older I will go deaf, that is why my family is learning sign language." 

I have to stop her and let her know that she will have hearing loss, but that hearing aides will help her to still hear. 

She starts again, "I run fast. Sometimes I beat boys in a race."

I am secretly happy that she didn't bring up that her kidneys will stop working properly. One less thing on her mind!

Abby holds her worries inside most of the time. She tells me on rare occasions that she talks to a friend at school about her condition. She doesn't talk to us about her fears very often. Her health problems started quite some time ago, almost 9 years ago. We had many years of unknown fears and tests and Doctor appointments. They definitely took their toll on her.

Things are easier now. It is easier knowing what they have. I don't have to seek out new Doctors frequently when we finally get to the end of the road of tests and ideas from sub par Doctors. 

Now we get to watch and wait, and live. For a moment, we get to enjoy this time, this healthy time. 



A couple of years ago, Quinn was really upset. He was insistent that he didn't want to be Quinn anymore. He wanted us to all call him Cody from now on. Cody was the name we debated calling him when I was pregnant with him. After some time with his distress, he finally told me that if he was Cody, then he wouldn't have the kidney problem anymore. He broke down and cried and begged me to call him Cody. 

It broke my heart that day. I wish we could remove diseases that easily.  

Part of having rare disease is more than just dealing with the actual sickness, but also dealing with the worry about the future. After we finally got the diagnosis, I would just stare at their pictures hanging up on the wall. I worried about their future, or lack of one. Questions would run through my head constantly. "Will they get to be married? Have kids? Go to college?" "WILL THEY BE HAPPY?"

It took me quite some time to stop asking those questions. Now I just live. We hope for the future and enjoy living right now.I am sure those questions will come back when their kidneys start failing. For right now, I want to enjoy this time. I don't want to worry their childhood away.


Behold, we count them happy which endure. Ye have heard of the patience of Job, and have seen the end of the Lord; that the Lord is very pitiful (TG translation meaning Compassion), and of tender mercy. 




Friday, March 4, 2016

Pioneer Woman's Creamy Tomato Sauce

Pioneer Woman's Creamy Tomato Sauce



One year for Mother's Day, I wanted a pasta dish for Dinner. I found a recipe from the Pioneer Woman I was curious about, so I asked Kevin to make it for me. We've been hooked ever since.  We make this on a regular basis. It goes great with Garlic Knots or Breadsticks!


Abby requests this almost every month for her night. This is one of her favorite meals. The thing that I love about it, is it is meat free and doesn't leave you wishing for the meat like other pasta dishes do.




Pioneer Woman's Tomato Cream Sauce

2 Tablespoons Olive Oil
2 Tablespoons Butter
1/2-1 Onion, finely diced
4 Cloves Garlic, minced
2 Cans Tomato Sauce, 15oz each
Salt and Pepper to taste
Dash of Sugar
Lawry's Garlic Salt
1 Cup Heavy Cream
Grated Parmesan Cheese
Handful of Fresh Basil
1 Pound Cooked Spaghetti or Fettucini

Heat Butter and Oil over medium heat. Meanwhile, chop the onion finely and mince the garlic. Once the pan is hot, saute the onion for several minutes till it is tender. Add the garlic and cook 1-2 minutes longer. In a food processor add the basil and some of the tomato sauce. If you desire a more pureed tomato sauce and don't like the onion crunch, add the cooked onion and garlic to the processor and puree. Add this back into the pan and add the rest of the tomato sauce. Season with salt, pepper, garlic salt, and sugar. Cook the Pasta as needed, reserving some pasta water if desired. Simmer for 15 minutes and add the heavy cream and a handful of Real Parmesan Cheese, and the grated Parmesan Cheese in the green container. Remove from heat and stir. You can either toss in the pasta and coat, or just pour the sauce directly over the pasta. We've never used the reserved pasta water. Add more basil if desired.


It bubbles very quickly. I love the orange sauce once you pour in the heavy cream. 


We prefer to puree the veggies.




Enjoy! 

Wednesday, March 2, 2016

Cheesecake

Cheesecake



Cheesecake is one of my favorite desserts. I've been making this since I was a teenager. I never wrote down my original recipe and I have been on the hunt for a good one for the past several years. I saw this recipe over at Mel's Kitchen Cafe, and I have been hooked since. I have made this quite a few times and it doesn't ever let me down. I don't even have to do a water bath, and it still doesn't crack. (Not that a cracked cheesecake really bothers me). 


I love how creamy the cheesecake is. It calls for Lemon Zest, which adds a nice flavor. I've tried it without the lemon and it still tasted great. 


Ingredients
Crust:
3 Cups finely ground Graham Crackers (about 40 squares)
2 Tablespoons Sugar
1/2 Cup butter, melted

Filling:
2- 8oz Cream Cheese, softened
1 Cup Sugar
3 Eggs
1 teaspoon Vanilla
1 Lemon Zest, finely grated
1 Pint Sour Cream



 Process the graham crackers in the food processor until they are finely grated. Add the sugar and mix. Meanwhile, melt the butter and combine together with the graham cracker crumbs. I usually do it in a separate bowl so it is easier to mix.
You can use pre packaged crust, but why would you want to? This is thicker and tastes better.


Once the crust is combined and pressed into a spring form pan, set aside and pre heat the oven to 325. In a separate bowl, mix the softened cream cheese until it is smooth. Add the sugar and beat until creamy. Add the eggs, and mix them one at a time. Scrape the sides of the bowl as needed, to combine everything together. Stir in the vanilla and lemon zest. Add the sour cream and mix with a spoon so it is not over mixed. Pour over the crust and bake at 325 for 50-55 minutes. It should jiggle slightly. Cool for 30 minutes and then refrigerate for at least 4 hours before serving. 


Baked to perfection!


Garnish as desired. I had some Raspberry Jam on hand and tried that first.



My favorite was a chocolate drizzle. I did about 1/2 cup chocolate chips with about 1/2 tsp coconut oil, and melted that in the microwave, and then drizzled it on the plate and eventually on the cheesecake.



 Enjoy!


Cheesecake
Ingredients
Crust:
3 Cups finely ground Graham Crackers (about 40 squares)
2 Tablespoons Sugar
1/2 Cup butter, melted

Filling:
2- 8oz Cream Cheese, softened
1 Cup Sugar
3 Eggs
1 teaspoon Vanilla
1 Lemon Zest, finely grated
1 Pint Sour Cream

 Process the graham crackers in the food processor until they are finely grated. Add the sugar and mix. Meanwhile, melt the butter and combine together with the graham cracker crumbs. I usually do it in a separate bowl so it is easier to mix.

Once the crust is combined and pressed into a spring form pan, set aside and pre heat the oven to 325. In a separate bowl, mix the softened cream cheese until it is smooth. Add the sugar and beat until creamy. Add the eggs, and mix them one at a time. Scrape the sides of the bowl as needed, to combine everything together. Stir in the vanilla and lemon zest. Add the sour cream and mix with a spoon so it is not over mixed. Pour over the crust and bake at 325 for 50-55 minutes. It should jiggle slightly. Cool for 30 minutes and then refrigerate for at least 4 hours before serving.